Preservation Rhinoplasty by the Ones Who Do It: A Worldwide Survey

Dorsal preservation (DP) rhinoplasty techniques, including surface techniques (STs) and foundation techniques (FTs) have garnered significant attention internationally over the past few years. The practice patterns and opinions from 117 of these surgeons were surveyed from a cohort of these surgeons who participate in an online Evidence-Based Rhinoplasty Research Group. The findings of the survey are merely a snapshot of the international rhinoplasty community's practices, yet did capture data from surgeons from a diverse geographic, years of experience, and training background. STs were most used for the bone changes, and the high-strip technique was preferred for the cartilaginous septal surgery. STs are mostly performed by younger surgeons (<10 years of experience), whereas FTs were more common in older surgeons (10-30 years of experience). STs were considered more stable (p < 0.001), more predictable (p < 0.001), and associate with a shorter learning curve (p = 0.015). Revision surgery rates were not different. Regarding why many surgeons using DP still perform structural rhinoplasty, the most cited concern was hump persistence/recurrence. In summary, among surgeons using DP rhinoplasty techniques, the majority perform DP in over half of their primary rhinoplasty surgeries, highlighting the importance of updating educational programs in medical training, conferences, and courses.